Background: Gestational Diabetes Mellitus (GDM) has been linked with later metabolic abnormalities in offspring due to subsequent overweight and obesity. In Sub-Saharan Africa, there is a paucity of data on the outcomes of children exposed to GDM in utero. Aims: The primary aim of this sub-study was to investigate the prevalence of overweight and obesity in 5 and 6-year-old children from GDM complicated pregnancies and macrosomia at birth in the same cohort. The secondary aim was to identify risk factors associated with overweight and obesity in these 5 and 6-year-old children. Outcome measures: The main outcome was the prevalence of overweight and obesity in these children as measured by their age-specific body mass index (BMI) and Z-scores. Additionally, the association between other risk factors, overweight and obesity was investigated. Methods: A cross-sectional sub-study design was employed nested within a larger study that is investigating the progression to type 2 diabetes in women managed for GDM during 2010 and 2011. Mothers who participated in the larger study were informed about the sub-study and invited to allow their children to participate in the sub-study. Written informed consent was obtained from the mothers for the sub-study. The following data were collected: anthropometric data at birth and pregnancy related information from the mothers’ hospital record, additional demographic, social and medical information by questionnaire from the mother and at the research center. In addition, the children were weighed and had their height measured using standardized methods. Anthropometry was standardized using WHO standards. Risk factors for overweight and obesity were tested using a BMI>1 Z-score cut-off, (as a binary variable) in a manual multivariate logistic regression model. Results: The sub-study recruited 176 participants; 78 boys (44.3%) and 98 girls (55.7%). The mean (SD) Z-scores for the children’s anthropometry at ages 5 to 6 years were 0.28 (1.40) for weight, 0.01 (1.07) for height and 0.37 (1.63) for BMI. The overall prevalence of macrosomia at birth (birth weight>4000 gm) was 12.3 % (95% CI 8.2-9.1). The overall prevalence of overweight in the 5 and 6-year-old children was 13.4% (95% CI 8.6-20.4), while the prevalence of obesity was 14.2% (95% CI 9.2-21.2). The combined prevalence of overweight and obesity was 27.6% (95% CI 20.6-35.9). The prevalence of macrosomia (P=0.53) or overweight/obesity proportions (P=0.37) at ages 5 to 6 years did not differ by gender. In multivariate logistic regression analysis, factors independently associated with the risk of overweight and obesity were: mothers’ oral glucose tolerance test 2-hour blood glucose level during pregnancy (AOR=2.06, 95% CI 1.14-3.74, P=0.02), birth weight (AOR=1.00, 95% CI 1.00-1.00, P=0.01), child’s age in years (AOR=0.03, 95% CI 0.002-0.29, P=0.004) and number of adults in the house (AOR=0.38, 95% CI 0.17-0.86, P=0.02). Conclusion: This is the first study to report the prevalence of overweight and obesity in children born from GDM complicated pregnancies, in the Western Cape, South Africa. The combined prevalence of overweight and obesity found in 5 and 6-year-old children exposed to GDM in the Western Cape is higher than overweight and obesity in children reported in other South African studies. This can imply a higher tendency towards overweight and obesity in children exposed to GDM which needs further exploration.

Aim: To investigate the preferred learning styles of learner nurses i.e. enrolled/staff nurses and auxiliary nurses, in nursing schools within public health facilities in the Cape Town Metropolitan district of the Western Cape, South Africa. Objectives: To determine individual learning styles of learner nurses registered for a training programme in a school of nursing. To establish the differences between the categories of learner nurses with regards to the learning style preference. To determine a possible relationship between demographic and educational background of the individual and the preferred learning style.

Blood glucose control with intravenous insulin therapy is one of the most frequently used treatment modalities to manage hyperglycaemia in critically ill patients. Almost all critically ill patients admitted in the Intensive Care Unit (ICU) will require blood glucose control to manage stress induced hyperglycaemia. Blood glucose control by means of intravenous insulin therapy is associated with reduced morbidity and mortality rates, which ultimately improves patient care outcomes. Although blood glucose control is beneficial for critically ill patients, however, it is potentially dangerous due to the side effects of insulin therapy, namely hypoglycaemia and hypokalaemia. As ICU professional nurses are responsible for blood glucose control in critically ill patients, it is therefore essential that they have adequate knowledge of blood glucose control measures to ensure patient safety and improve outcomes. The aim of this study was to determine ICU professional nurses’ knowledge of blood glucose physiology and blood glucose control in critically ill adult patients in a public tertiary hospital in the Western Cape Province. The study was non-experimental, descriptive and quantitative in nature. Data was collected by means of an anonymous, self-administered questionnaire in June 2013. Ethical approval to conduct the study was obtained from the University of Cape Town’s Health Sciences Faculty Human Research Ethics Committee. Permission to conduct the study in the specific research setting was obtained from the Hospital Senior Medical Services Manager. Descriptive and correlational statistics were used to analyse the data.

Includes bibliographical references / Background: Errors in communication are prevalent in healthcare and affect patient safety and cause unnecessary patient deaths. Reporting early signs of physiological or clinical deterioration could improve patient safety and prevent 'failure to rescue' or unexpected intensive care admissions, cardiac arrest or death. The structured Situation-Background-Assessment-Recommendation (SBAR) communication tool enables nurses to provide doctors with pertinent information about a deteriorating patient in a logical order, based on a complete assessment. In addition, nurses have increased confidence in their findings and are better able to initiate a call and to convince a doctor to provide orders promptly or see a patient. Aim: The aim of this sub-study of a randomized controlled trial was to develop and validate a modified SBAR communication tool incorporating components of a local MEWS vital signs observations chart. Methods: The modified SBAR communication tool was developed following a review of available published examples and validated by employing a mixed methods approach: 1) cognitive interviews (n=3 nurses, 2 doctors), 2) determining the index of content validity with nurses (n=5), physicians (n=5) and surgeons (n=8) and 3) inter-rater reliability testing, with calculation of kappa values (n=2 nurses). Results: Cognitive interviews prompted more changes to the modified SBAR communication tool than determined by the content validity index. For cognitive interviews, there were 15/42 (35.71 %) modifications: 11 items were added (26.19 %) and three removed, (7.14 %) resulting in 49 items whereas for content validity index there were 4/49 (8.16%) modifications, 5/49 (10.20%) items removed and one item added (2.04%). Four of 49 items (8.16%) rated as relevant by <70% of nurses and doctors were revised or deleted. No additional modifications were needed following review by surgeons, as all items were rated as relevant by the pre-determined ≥70% of experts. Inter-rater reliability of the SBAR tool was established by two nurses who were mostly in substantial to full agreement on 37/45 items on the modified tool. The exceptions were: 'Calling from' (Cohen's Kappa-0.05) and 'this is a change from' (Cohen's Kappa-0.07), representing agreement below the level of chance. However, the high percentage agreement and nature of the questions suggest that the questions are sound. Percentage agreement amongst participants for these items was 91 % (95% confidence interval (CI): 71 to 99 ) and 86% (95% CI: 65 to 97 ) respectively. Deciding whether a doctor should see the patient now (Cohen's Kappa 0.09) or in the next 30 minutes, achieved fair agreement (Cohen's Kappa 0.20). This reflects a difference in clinical judgement as the decision when to call for assistance depended on the individual nurse's clinical judgement. IRR was not possible to test on 4/45 items, as those items required a response by the person being summoned. Overall, nine of 42 items were removed, 12 were added and 19 substantially modified, leaving 45 items. Conclusion: The modified SBAR communication tool was valid and reliable for use in a local context in conjunction with the Cape Town Modified Early Warning Score (MEWS) vital EWS) vital signs chart.

Registered nurses in clinical settings, through years of training combined with experience, become empowered with valuable knowledge and skills. The majority of these registered nurses are employed in public hospitals, caring for patients from culturally diverse backgrounds who face economic, psycho-social, and, in particular, physical challenges. Such conditions often provide a rich environment to undergraduate nurses for experiential learning. The experienced registered nurses, working in this rich environment, are well positioned to fulfil a crucial role in transferring, developing and enhancing skills for educating undergraduate nursing students. Their role in the development of undergraduate nursing students in the clinical environment should never be underestimated or under-utilised. The clinical environment should be considered as the most important resource for developing the confidence and competencies of undergraduate nurses. It is within this background that this research study was undertaken. The aim of this research study was to contribute to the teaching and learning roles and functions of registered nurses working in the surgical wards at the study setting in terms of teaching undergraduate nursing students. The researcher intends to make certain recommendations for the improvement of teaching and learning for undergraduate nursing students in the clinical context. In addition to exploring the feelings and perceptions of registered nurses regarding their teaching role, the minor dissertation seeks to explore some of the misconceptions and challenges relating to the nature, extent and responsibilities of this teaching role. I therefore set out to answer the following research question: “How do registered nurses at a Western Cape academic hospital perceive their teaching and learning role as clinical teachers?â€

The Aim of the Study: The aim of this study was to explore the experiences of ICU nurses performing post mortem care in an intensive care unit at a private hospital in Cape Town. In addition, the study set out to identify educational needs and to offer recommendations that may address these needs for this sample of ICU nurses. Background to the Study: Post mortem care (care after the death of a human being) is still viewed by contemporary society as a taboo and clandestine aspect of life and is more often avoided both in conversation, writing and thinking. In many hospitals and other healthcare facilities, post mortem care is performed behind closed doors, in which an aura of mystery is created as to what happens to the dead body in this scenario. The nurses’ experience of post mortem care differs from that of other occupational groups (ambulance officers, medical practitioners and police) as the nurse sees the body before and after death and has an established relationship with the person who has died. The practical procedure of post mortem care is widely explored by many authors using various procedural guidelines and/or manuals. However, little is known about the nurse’s experiences of post mortem care. Methodology: A qualitative research design using a descriptive method was used to explore the experiences of a purposive heterogeneous sample of six ICU nurses who were working in an ICU of a private hospital in Cape Town. Data Collection and Analysis: A semi-structured interview which was audio-taped and transcribed verbatim was employed to collect data. Colaizzi’s (1978) seven step inductive method was used to formulate naïve themes. Following participant feedback, three main themes emerged: (i) care of the dead body; detachment and (iii) thanatophobia. Findings: Safeguarding the integrity and physical appearance of the dead body was the major finding and of the utmost priority for the participants in this study. Regardless of how the ICU nurses felt about death, providing professional and quality care to the dead body and the family was seen as significantly important. The ICU nurses, whilst performing post mortem care, experienced detachment from various relationships. This comprised of the ICU nurse detaching him/herself professionally and emotionally from the dead patient, the family and him/herself from the death experience. This ‘unspoken’ experience of thanatophobia became apparent when the ICU nurses were confronted by the reality of their own deaths. Conclusion and Recommendations: These three themes were discussed in relation to the available literature and recommendations put forward for education and nursing practice and further research.

In the context of the HIV/AIDS pandemic in South Africa Disability Grants are playing a major role in alleviating poverty. In HIV-affected households in the community of Masiphumelele in Cape Town they are most often the only source of income. The high unemployment rate in South Africa together with limited welfare provision may result in HIV-infected persons having to face the dilemma of losing a grant or continuing to adhere to highly active antiretroviral therapy (HAART) once clinically stable with an undetectable viral load. Non-adherence could lead to drug resistance and would thus be detrimental to health, with increased risk of infection and a higher burden of care. Persons who adhere to the antiretroviral (ARV) regime are more likely to have a reduced viral load and an increase in CD4 count, which results in the loss of the Disability Grant since they are then classified as able to work. Aim of the study: The aim of this study is to explore HIV positive persons' perceptions of the usefulness of Disability Grants and their contribution to health and well-being while on HAART. Objectives of the study: * To determine perceptions of the purpose and function of Disability Grants among persons who are HIV positive in the Masiphumelele community. * To explore with participants whether their perception of Disability Grants may affect decision-making with respect to adherence to ARV therapy.

This purpose of this study is to examine the effect of a forced mass interinstitutional relocation on the quality of life for two groups of nursing home residents. A conceptual model for this study. The Relocation Adaptation Model (RA), was derived from both empirical and conceptual literature on social gerontology.The study population was randomly selected from the more cognitively able nursing home residents. A combination of methodologies was used to collect the data necessary to make comparisons over a 17 week time period. Three recognised instruments were used: the General Health Questionnairre-20, The Affectometer 2 and the Katz Index of Activities Of Daily Living. Other instruments were developed by the researcher to collect relevant data. An audit of participant's records was included. Guided interviews were also carried out. The study found that the quality of life of residents in a nursing home is effected following a forced interinstitutional relocation and that the level of medication useage by participants may have been a significant factor in the response to the relocation.Few mass relocations of nursing home residents have taken place in Australia. These will increase as existing nursing home buildings age and deteriorate. This study is unique. The researcher believes it is the only Australian study of this nature to have been carried out.

No description available.

No description available.